Affordable Care Act

Health care helped propel Democrats to victory in a wave of elections in 2018, and it remains a top issue for voters heading into 2020.

But the conversation has changed over two years; while in the last midterms health care debates revolved around protecting the Affordable Care Act, also known as Obamacare, after GOP attempts to repeal it, presidential candidates ahead of 2020 are focusing more on overhauling the entire health care system.

This article first appeared in the St. Louis Beacon,Aug. 5, 2009 - The country is in the midst of an intense debate regarding whether the federal government should make health insurance affordable for all. Such an expansion of the health-care system will likely cost between $1 trillion and $1.5 trillion over 10 years, according to the nonpartisan policy think tank, Center for American Progress (CAP). This, of course, comes on top of the financial sector bail-out and the economic stimulus package, each costing several hundred billions of dollars.

This article first appeared in the St. Louis Beacon, March 19, 2010 - -The largest percentage of Missourians with health insurance, either employer-provided or individually bought, lives in Republican Rep. Todd Akin's second congressional district in west St. Louis County.

Missouri likely would not have to spend any additional money to expand Medicaid to insure more low-income people, according to a report from the Washington University Center on Health Economics and Policy.

The state spends nearly $4 billion to provide Medicaid to people with disabilities, pregnant women, children and some seniors.

Researchers say adding people who make up to 138 percent of the federal poverty rate – close to $17,000 annually – likely wouldn’t cost Missouri extra funds, because the state would receive increased federal funding under a Medicaid expansion.

This article first appeared in the St. Louis Beacon, April 11, 2011 - Missouri Attorney General Chris Koster appeared to have caught many current and previous political colleagues off-guard today with his friend-of-the-court brief that challenges the mandate in the federal health-care law that requires most Americans to buy insurance by 2014.

U.S. Sen. Claire McCaskill predicts there won’t be any congressional action – beyond symbolic votes – to protect or replace the Affordable Care Act before she leaves office.

And she’s not sure whether a government shutdown can be avoided, if President Donald Trump wants it.

McCaskill, a Democrat, said in an interview for St. Louis on the Air that she isn’t surprised by Friday’s ruling by a Texas judge to toss out the entire Affordable Care Act, although she disagrees with his decision.

Americans have until Saturday to sign up for coverage on the federal, online insurance marketplace. The Affordable Care Act set up healthcare.gov to help people find affordable health care and access income-based subsidies to help pay for it.

But the federal government is cutting funding for outreach and the enrollment period has been cut in half. As a result, fewer people are signing up nationwide. Missouri has one of the highest drops in enrollment.

A new survey from the U.S. Census Bureau found the Missouri uninsured rate remained steady at 9.1 percent in 2017 despite several Congressional attempts to gut the Affordable Care Act and the repeal of the individual mandate, the requirement that all Americans have insurance.

Missouri’s percentage of uninsured people is in line with the national rate of 9 percent. The number of uninsured people nationwide has been falling since 2013, when it was 13.4 percent.

When Missourians go to healthcare.gov to buy health insurance, they likely won't be shocked by double-digit increases this year, according to data filed Wednesday with the state’s insurance department.

Three existing carriers — and one new entry into the market — will offer plans with smaller increases than previous years. Two insurers offering healthcare.gov plans are asking for modest rate increases.

Healthy Alliance Life Insurance plans an average increase of about 4 percent, and Cigna’s plans will increase about 7 percent. Centene's Celtic Insurance plans an average decrease of 9 percent.

The rising costs of insurance plans available through the federal healthcare.gov website may make them unaffordable for some people in Missouri and Illinois.

Premiums for exchange plans on healthcare.gov have become more expensive, but most people who buy exchange plans on healthcare.gov receive tax credits to help them offset the cost and are insulated from rising costs. But those who don’t receive those credits bear the brunt of those increased prices.

Missouri and Kansas have joined 18 other states in seeking to have the Affordable Care Act declared unconstitutional following Congress’ repeal last year of the tax penalty associated with the individual mandate.

In a lawsuit filed late Monday in federal court in Texas, the coalition of 20 mostly red states claimed that the elimination of the tax penalty for those who don’t buy health insurance renders the entire healthcare law unconstitutional.

Once again, people who don’t get health insurance through their job are logging into online market places set up by the Affordable Care Act to buy it on their own. This year, the enrollment season is shorter — six weeks — but business is brisk.

In the first four weeks of this year’s enrollment season, 78,676 Missourians enrolled in a plan, according to numbers released Wednesday by the Centers for Medicare and Medicaid Services. That’s about 17,000 more people than were signed up during the same period last year.

Open enrollment for people who buy their own health insurance starts Wednesday and ends Dec. 15. That means there are only 45 days to shop for coverage. The shorter enrollment period this year is just one of the changes to the process for buying insurance under the Affordable Care Act.

Here are five important factors to keep in mind if you plan to sign up for ACA coverage for 2018.

1. The health law has not been repealed.

Despite the efforts of President Trump and the Republican-led Congress, the Affordable Care Act remains the law of the land.

On Friday’s St. Louis on the Air, Don Marsh talked with Saint Louis University health law professor Sidney Watson about the just released 2018 premiums for policies through the Affordable Care Act and discuss how Missourians and St. Louisans will fare.

After another Republican Senate loss early Friday, Missouri and Illinois senators are calling for a return to bipartisan talks to overhaul the nation’s health care law.

They include U.S. Sen. Roy Blunt, a Missouri Republican, who had tried to help his party’s leaders come up with the votes needed for a trimmed-back version of a bill that would have repealed key provisions of the Affordable Care Act, the signature achievement of former President Barack Obama.

MONROE CITY, MO. — The closest emergency room is 20 miles east on the highway. That’s why it isn’t unusual for people experiencing heart attacks, blood clots and strokes to show up at Dr. Rodney Yager’s clinic on Main Street in Monroe City.

Yager, who grew up in the area, can handle the fast pace of a small-town clinic. What worries him more is how federal health care policies being shaped in Washington, D.C., could affect his patients.

Anthem Blue Cross Blue Shield, one of Missouri’s largest insurers, no longer covers emergency room visits that it deems unnecessary.

The policy aims to save costs and direct low-risk patients to primary care physicians and urgent care clinics. But doctors say patients may avoid going to a hospital when they really need it, if they fear a large bill.

Centene Corp. will step into the breach created by Blue Cross and Blue Shield of Kansas City’s decision last month to exit the Affordable Care Act marketplace in 2018.

The Clayton, Mo.-based insurer will begin selling health plans next year in all 25 western Missouri counties that Blue KC’s withdrawal would have left “bare” — that is, without any insurer offering health plans in the individual market.

The nonpartisan Congressional Budget Office weighed in on the Senate health care bill on Monday, saying that 22 million people would lose health coverage in the next 10 years under the Senate's plan. Of those, 15 million would lose Medicaid coverage. It's projected to lower the deficit by billions over 10 years, and also cut taxes on corporations and the wealthy.

Republicans in the U.S. Senate said Tuesday they would delay a vote to pass their plan to replace the Affordable Care Act.

The Senate's Better Care Reconciliation Act would reduce the federal deficit by $321 billion and leave 22 million more people uninsured by 2026, according to Monday’s estimate by the Congressional Budget Office. Like the House plan, it slashes Medicaid and allows states to redefine what’s covered in a basic health insurance plan, in a bid to lower costs.

Next year, Blue Cross Blue Shield of Kansas City will leave the individual health care marketplace in Missouri that was set up under the Affordable Care Act. And when it does, about 18,000 patients in 25 western Missouri counties will lose their health insurance. If those enrollees sign on to Healthcare.gov this fall to buy a replacement plan, they may have no options to choose from.

Three weeks after Blue Cross and Blue Shield of Kansas City said it will pull out of the Affordable Care Act exchange in 2018, Centene Corp. says it plans to offer coverage through the exchange in Missouri and Kansas.

The St. Louis-based insurer already has a presence in both states administering Medicaid plans, but the move to sell individual and small group health plans is new.

A Republican proposal to gut the Affordable Care Act narrowly passed the U.S. House of Representatives and now the U.S. Senate is crafting its own bill to reshape the nation’s health care system. Elected officials have held few town halls to hear from constituents in the St. Louis area about what they want in a health care bill, sparking demonstrations outside representatives’ offices.

Barb Fleming had built a small business selling tableware and wedding gifts. But that career nearly came crashing down around her in 2008, when her doctor found a lump in her breast.

Months later, Fleming, of Bel-Nor, in St. Louis County, would find herself in Missouri's high-risk pool: a pricey, state-managed insurance plan that covered people with pre-existing conditions. The programs were phased out by the Affordable Care Act, but could return in the sweeping health care proposal passed this month by House Republicans.

U.S. Sen. Claire McCaskill said Thursday she thinks it’s important for Congress to “repair, not repeal” the federal Affordable Care Act, which she says is under threat by the Trump administration’s hints that it won’t continue to pay subsidies to participating insurance companies.

About 40 counties in Missouri have only one insurer participating in the Affordable Care Act’s insurance marketplace.